Dec 2020 The Hearing Journal

The COVID-19 pandemic has resulted in many changes in health care, including the postponement of nonessential surgeries, shifting of in-person office visits to virtual, access restriction for visitors and interpreters, and the widespread wearing of face masks. Although the pandemic presents additional challenges particularly for people with hearing loss, it is important to stay on top of your health maintenance visits since early diagnosis and treatment often lead to better outcomes. These days, medical and dental practices and hospitals are taking extensive safety precautions, including screening patients and staff for COVID-19 symptoms, and cleaning rooms and surfaces between patient visits. It's all about choosing the best options for you and preparing in advance. Consider these tools and strategies to help address communication and other hearing-related challenges you may face during appointments.

medical allyCONNECTING WITH A MEDICAL ALLY

Health care is a TEAM sport! Like all teams, medical professionals have different roles and work together to create comprehensive care. Look beyond the doctor. Many facilities have physician associates (PA) and advanced practice nurses or nurse practitioners in addition to registered and licensed nurses and medical assistants. These members of the team are often easier to reach, can handle many issues, and have regular check-ins with the doctor.

It's especially helpful if you can identify a medical ally—someone in the office or hospital who understands your needs and can make things go as smoothly as possible. This person may be the practice manager, an assistant, or a medical navigator, for example. Ask who can best assist you with communication issues and contact that person before your visit. Connect with a medical team member to arrange necessary accommodations and to answer any questions. These contacts can be done electronically, using a patient portal or email, if available, or by telephone or virtual (video) visit.

IN-PERSON VS. VIRTUAL VISITS (OR BOTH!)

With hearing loss, it's important to find out what to expect for an in-person or virtual visit. For example, will the clinician be wearing a mask? Will it be via video or telephone? Are translation services (including interpreters and captioning) available? Can you use your own technology? Sometimes in-person visits may be needed, such as when a physical exam, test, or procedure is planned.

Virtual visits are new to many patients and providers, and we are all trying to make them work better. You can request that someone contact you prior to a virtual visit to assist with technical details and discuss any hearing assistive devices or other accommodations you may want to use. There is also the option of a virtual visit with video and assistive devices in addition to being in-person for tests or procedures.

Think about a medical visit not as a single event but a process that includes what happens before and after.

  • Before a visit, inform your medical team about your communication needs and inquire who can help you arrange for accommodations. Remember to bring your communication tools and fully charged technology. Consider sharing this communication tip sheet with your health care provider: https://bit.ly/34yKH9Y.
  • During the visit, it may help to remind health care team members to speak louder, add pauses between words, and rephrase.
  • After the visit, you can schedule a follow up virtual call with a health care team member to cross-check details, confirm your understanding, and have another opportunity to connect.

EXPLORING TECHNOLOGY OPTIONS

Here's where we get creative! A variety of practical tools can help. These include patient portal messaging, speech to text apps (Google Live Transcribe, Ava, and Otter), videoconferencing (including family and interpreters) such as Google Meet with automated captions, assistive listening devices, and clear masks. Also, consider using a phone or an app that can make virtual health visits accessible via captions (InnoCaption, Caption Call, Hamilton CapTel, and Spring Relay) or sign language (Global, Convo, Purple, Sorenson, and ZVRS). Finally, inquire about accommodations that the facility may have.

HANDLING UNEXPECTED BARRIERS

Sometimes, even with the best planning and good intentions, you may experience an unexpected communication barrier or difficulty. If that happens, let a health care team member know right away. Ask for a pause, stay positive, and work together on a solution. If things can not be improved immediately, consider requesting an accessible follow-up phone or video visit with captions or a sign language interpreter. This can help fill in what was missed and provide you with a chance to ask additional questions. Don't give up! Barrier-free and meaningful communication is essential to your health and wellness!

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